Medicare Compliance & Reimbursement - 2014 Issue 8
Reader Question: Give a Reason for Interpretation #2
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Article Overview
This article answers a coding question about whether a specialist can separately report interpretation of an anorectal manometry study performed elsewhere, and whether an office visit may also be reported when the patient is seen in the practice. It is relevant to ob-gyn, urogynecology, and medical coding staff who handle diagnostic test interpretation, E/M reporting, and documentation requirements. The discussion focuses on the general circumstances under which an additional review may be considered billable and what supporting documentation is expected.
Why This Topic Matters
It helps practices understand when interpretation work may already be accounted for and when a separate evaluation service may need to be supported by documentation. It also highlights the importance of clear records when a provider is reviewing outside test results as part of patient care.
Article Sections
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Question
The reader describes a urogynecology practice scenario involving outside testing, interpretation review, and whether an office visit can also be reported.
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Answer
The response discusses general billing and documentation considerations for reporting interpretation-related services and an associated E/M service.
What You Will Learn
- How the article frames separate interpretation of an outside diagnostic test
- What types of documentation are discussed for supporting a separately billable service
- How the article approaches the relationship between interpretation review and an office E/M service
- When a second review of outside results may be considered in general terms
Who Should Read This
- Medical coders
- Billing staff
- Ob-gyn practices
- Urogynecology practices
- Physician documentation staff
Codes Discussed
Modifiers Discussed
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